Cross-sectional study shows that support services influence enrollment decisions in lung cancer patients, highlighting key barriers.
137 Background: Though clinical trial (CT) participation barriers are well-characterized, there’s limited evidence on strategies to overcome them. We conducted a cross-sectional study to assess the relative impact of specific support services on patients’ (pts) decision to enroll if offered a CT. Methods: We thematically categorized known CT participation barriers and mapped their corresponding pt support resources, reported publicly from sponsors, pt groups, and health systems to develop 4 survey items on pt’s perceived helpfulness of each resource on their trial participation decision (5-point Likert scale). After IRB approval, pts with current or prior lung cancer were recruited (12/30/24–1/10/25) via Lung Cancer Research Foundation & social media. Analysis included descriptive statistics, response grouping, and coding of free-text responses. Results: Overall, 314 pts with lung cancer completed the survey, 58% aged 40-64y, 37% 65y+, 6% AYA 18-39y; 78% were female, 62% had metastatic disease, 78% never participated in a CT. Four key thematic solutions with respective support services targeting CT access barriers were identified: Enhanced Expert Support: Over 90% of pts report having increased support from professionals—inc. access to CT team, frequent check-ins about symptoms, and personalized guidance from a trained trial navigator—would make them more likely to enroll. Pts 65y+ were more likely to enroll if given more opportunities to report symptoms (93% vs 82%, p 0.008). Cost-Informed Pt Engagement: Over 80% were more likely to consent if (1) told their expected out-of-pocket costs during CT participation for services not covered, (2) provided financial resources, inc. full medication coverage for side effects, travel for CT activities; 62% were more likely to consent if housing, gas, and meal costs were covered. Multi-Modal On-Demand Education: Over 80% were more likely to consent if provided on-demand education, inc. (1) video from the PI on side effects & management, esp. pts aged 65+ (87% vs 77% of pts < 65y, p 0.038); (2) one-pager on key CT aspects ( process, time commitment), esp. non-partnered pts (92% vs 79% for partnered pts, p 0.021). Over 70% also wanted a list of questions to ask their medical team, diagnosis info, and a video from the PI on CT design and consent process. Time-Conscious Pt Experience: Over 90% were more likely to consent if offered coordination of appointments/scans & increased flexibility with scheduling. Over 80% also ranked having video/ phone visits and optional blood draws at home/location of choice to be influential in consenting. Conclusions: Our findings highlight four key solutions that influence CT participation and offer actionable recommendations—such as expert support, clear education, and time/cost transparency—for sponsors, regulators, and others to proactively make CTs more accessible.
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Preeshagul et al. (2025) studied this question.
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